247 Av. Dunbar, Suite 202, Mont-Royal, QC, H3P 2H4
info@rkassurance.ca
514-360-4420
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Home
Insurance
Auto
Home
Commercial
Claims
About us
Contact us
Modifications
Get a Quote
Home
Insurance
Auto
Home
Commercial
Claims
About us
Contact us
Modifications
Home
Insurance
Auto
Home
Commercial
Claims
About us
Contact us
Modifications
Assurena Insurance Agency is an independent insurance brokerage agency that carries some of the best coverage options in the entire New USA.
Our Contacts
88 Centre Street North,
Toronto L4W 1C9
advisor@assurena.com admin@assurena.com
+1 (419)-507-0468
+1 (213)-345-0468
Working Hours
Monday
9.00 - 5.00
Tuesday
8.00 - 5.00
Wednesday
8.00 - 5.00
Thursday
8.00 - 5.00
Friday
8.00 - 4.00
Satureday
Closed
Sunday
Closed
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Auto Insurance Modification
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Auto Insurance Modification
Modification Request Form
In less than 2 minutes, we’ll receive your modification request and contact you very quickly!
Existing Client: Auto Policy Details
First Name
*
Last Name
*
Policy Number
Enter your policy number
Contact Number
*
Email Address
*
Type of Modification
*
Change of Address
Addition of Vehicle
Change of Vehicle
Removal of Vehicle
Transaction Date
*
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Street Address
*
Enter your new address
Apartment, suite, etc
City
*
Postal Code
*
Policy Modification Details
Moving Date?
*
Day
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Month
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1
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5
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11
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Year
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2124
2123
2122
2121
2120
2119
2118
2117
2116
2115
2114
2113
2112
2111
2110
2109
2108
2107
2106
2105
2104
2103
2102
2101
2100
2099
2098
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2096
2095
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1993
1992
1991
1990
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1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
When did you move here or when will you move here?
Name of registered owner
*
Vehicle to be substituted/replaced
*
Vehicle to be removed
*
Year
*
Make
*
Model
*
VIN/Serial Number
*
Where will the vehicle be parked?
*
Vehicle Parking
Street
Driveway
Garage
Distance to work or school
*
How many KM to go to work or school one way?
How many kilometers will you do per year?
*
Is there an anti-theft system?
*
TAG/Domino
Sherlock
None
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